DR. STACEY MARIE KISTING DC
NPI 1093896094
Chiropractor in Moline, IL
About Dr. Stacey Marie Kisting Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STACEY MARIE KISTING DC (NPI 1093896094) is an individual chiropractor in Moline, Illinois and active in the NPI registry since October 2006.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Stacey Marie Kisting Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stacey Kisting reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North Fort Myers, FL 33903
- Reassigned Medicare billing, Florida enrollment
- 7 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stacey Kisting's NPI number?
The NPI number for Stacey Kisting is 1093896094. It was assigned to this individual provider in the NPPES registry on October 17, 2006.
Where is Stacey Kisting located?
Stacey Kisting practices at 3450 38th Ave Ste 4, Moline, IL 61265. The listed phone number is (309) 764-7200.
What is Stacey Kisting's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Stacey Kisting enrolled in Medicare?
Yes. Stacey Kisting is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stacey Kisting's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Kisting reassigns Medicare benefits to Vita Nova Limited Inc (North Fort Myers, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacey Kisting's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stacey Kisting was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Stacey Marie Kisting, DC · NPI 1093896094
Chiropractor provider in Moline, Illinois. Individual provider, active in the CMS NPPES registry since October 17, 2006.
## Identity
- **NPI:** 1093896094 (Entity type: Individual)
- **Enumerated:** October 17, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3450 38TH AVE, STE 4, Moline, IL 61265-6409
- **Phone:** (309) 764-7200 · **Fax:** (309) 764-7750
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Vita Nova Limited Inc (NPI 1659919090, North Fort Myers, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1093896094) · Data from the CMS NPPES public registry.